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Inspection on 12/05/05 for 70 and 72 Worting Road

Also see our care home review for 70 and 72 Worting Road for more information

This inspection was carried out on 12th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users are involved in a variety of activities outside of the home. They may attend day services or sheltered workshops, have paid or voluntary employment, take part on college courses or spend time at home. At home they responsibilities in the running of the home and participate in the household chores. Evenings can also be busy with some attending a social club run by Mencap, a sports club for disabled people, woodwork evening class and a monthly disco. Great attention is given to service users communication needs and pictures are used widely around the home on notices and for allocating chores and choosing the menus. The manager puts great store in involving service users in the decision making process of the home and there are monthly service user meetings. Health and safety checks and servicing of equipment is being carried out effectively. Areas of activity where service users may be exposed to risk are being diligently identified and plans written in relation to this.

What has improved since the last inspection?

The standards, which the inspector looked at during the last inspection, were all satisfactory. At the last inspection the inspector suggested that information be gathered regarding service users wishes in relation to death and dying. This had been done.

What the care home could do better:

The assessment and care planning process would benefit from further development. It would not be clear to a member of staff unfamiliar with the service users, the way in which they should be supporting them. Inappropriate and worn dining chairs in the conservatory must be replaced. The stained carpet must be dealt with and the curtains shortened. A detailed procedure covering the recording, handling, safekeeping, safe administration and disposal of service users` medication is needed. Service users were not aware of the complaints procedure. It would be a good idea for staff to reissue copies to the service users and explain it to them.

CARE HOME ADULTS 18-65 70/72 Worting Road Basingstoke Hampshire RG21 8TP Lead Inspector Wendy Thomas Unnannounced 12.05.05 11:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 70/72 Worting Road Address Basingstoke Hampshire RG21 8TP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01256 844057 Advance Housing & Support Limited Miss Catrina Jean Knapp CRH 8 Category(ies) of Learning Disability - LD - 8 registration, with number of places 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23.11.04 Brief Description of the Service: Advance Housing and Support Ltd. are the providers of care at 70/72 Worthing Road. The home comprises of two semi-detached properties that have been converted into one home, and is registered to provide care for up to eight people who have disabilities. Service users have a single bedroom with en-suite bathroom and have shared communal space within two lounges, two kitchens and a conservatory. there is an enclosed garden and parking facilities to the rear. The home is situated in a residential area, close to the town centre of Basigstoke and is accessible to local amenities. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on Thursday 12 May 2005 between 11:00 and 18:00. Initially there was only one service user at the home but the inspector also spent time with three other service users as they arrived home later in the day. The staff were undertaking a team building day and the home was being staffed by agency staff who had worked in the home before. The manager returned to the home around the middle of the day and the inspector also spoke with her. A partial tour of the premises was also carried out and time was spent looking at care records. What the service does well: What has improved since the last inspection? The standards, which the inspector looked at during the last inspection, were all satisfactory. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 6 At the last inspection the inspector suggested that information be gathered regarding service users wishes in relation to death and dying. This had been done. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 4 The admission process enables potential service users to make informed decisions about whether this was the right home for them. EVIDENCE: At the time of the inspection there were two vacancies for service users. The manager explained that one person was preparing to move in. They had made five visits to the home including two overnight stays. They had already been known to the other service users, who were happy at the prospect of them joining the household. The inspector saw a detailed assessment provided by social services and risk assessments that had been carried out by the home. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Greater detail in service user plans would ensure consistent support for service users. More regular reviews and updating would ensure that changing needs of service users were being met appropriately. Service user consultation ensures that service users’ views are sought and that they participate in all aspects of life in the home. The risk assessment process supports service users. EVIDENCE: The inspector examined two service user plans. One contained a personal planning booklet with relevant information about the service user, however this had not been reviewed and updated as required, the last date being 2003. Another service user’s personal plan included two goals. These had been set in July 2004 but there was nothing to state what progress had been made or whether/when the goals had been achieved. Care plans were poor giving little detail of the service users’ support needs. These must be improved. It is strongly recommended that the manager research care planning formats and processes to implement an appropriate format in the home. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 10 A service user’s risk assessments were examined. A wide range of potential risks had been identified and satisfactorily assessed in May 2004. They had been reviewed in November 2004. The inspector suggested to a service user that they look at their care plan together. The service user commented, “What’s that then? No one’s told me about that.” Service users should be fully consulted and involved in developing their care plans. Another service user did know that there were records about them kept in the office. Throughout the home notices had appropriate methods of communication. The fire evacuation notices consisted of four pictures showing the action to be taken. There was a notice board with photographs of the staff that would be working that day. The system used for menu planning was very impressive, with good quality photographs of different constituents, which could be made up together on a Velcro board to denote the meals chosen by the service users. Picture boards were being used to show the household chores allocated to each service user that day. Service user meetings take place every month and notes are kept. The service users spoken with expressed satisfaction with the way in which they were consulted about the running of the home. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, and15. Service users benefit from a range of activities inside and outside of the home and being able to move freely around the local community, accessing local facilities and mixing with people not living in the home. EVIDENCE: The manager explained that over the past year the service users have become much more involved in activities outside the home. Service users now use a variety of day services/occupational facilities, attend college courses and an advocacy group, and utilise services assisting them into paid or voluntary work. One has a paid job at a supermarket and another is a volunteer in a charity shop. The service users spoken with expressed satisfaction with the activities they were involved in. Service users are often out in the evening, some attending a social club run by Mencap, a sports club for disabled people, a monthly disco, and a woodwork evening class. Other service users said that they would go out on their own for a walk or to a pub either on their own or with a member of staff. One service user described having recently been to see the film “Hitchhikers Guide to the Galaxy” and their plans to go and see the show “Mary Poppins” in London. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 12 One service user was at home when the inspector arrived at the home. They indicated that they were happy at the home and were content to get on with their colouring and not engage with the inspector, although they did later show the inspector round part of the home and their bedroom. The other service users spoken to enjoyed the activities they were involved in and were happy with their activity level. One service user described going to the gym on their own. Service users told the inspector about their holidays. Two had been to Malta with two members of staff a few years ago. Several mentioned going to a social services short breaks service on Hayling Island. One described a holiday they were planning to take with their parents. The manager explained that service users have become more involved in the tasks involved in running the household such as cleaning and shopping. One service user described with pride the household tasks they had done the day before with a member of staff and another informed the inspector that they took it in turns to help the staff with the cooking. They said they like doing that. A service user confirmed that they get up in the morning and go to bed when they like. The inspector observed a number of board type games in the conservatory that service users could play together. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 and 21. More comprehensive care plans would ensure that service users’ personal care was being delivered in the way prefer/require. Service users’ healthcare needs are referred to the appropriate healthcare professionals. Service users’ safety with regard to the administration of their medication is put at risk by the absence of a comprehensive medication policy EVIDENCE: Service users asked, said they were happy with the support that they received from staff. The care plans, however did not give sufficient information for a member of staff unfamiliar with the service users to be able to support them properly. The manager and service users described healthcare professionals who support them. Records were seen of service users’ medical appointments and the details of the consultations. It is recommended that outcomes such as the results of tests or when a follow up appointment was made be added to this. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 14 Medication is kept securely in the office. One service user described how it is their responsibility to go and take their medication there. An aide memoir for staff administering medication was seen taped to the outside of the medication cabinet. In order to promote privacy service users take their medication in the office, one at a time. Although there was the aide memoir there was no full medication policy or procedure. A requirement is made that one is developed. A recommendation in the previous inspection report requested that service users’ spiritual and cultural wishes should be obtained and should include their wishes around death and dying. There were records in service users’ files to show that this was being done. There was a comment in one to say that the issue of the person’s will needed to be followed up. The manager agreed to do this. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Promotion of the complaints procedure would help service users to follow the procedure if they had any cause for complaint. EVIDENCE: One of the service users spoken with was not aware of the complaints procedure, although they did say that they would discuss concerns with the manager. The inspector discussed making the complaints procedure available to service user and providing them with an explanation as to its purpose and how to use it. The manager thought reissuing service users with a complaints procedure would be of little value. The inspector recommend that this is done so that service users are reminded of the process, and so that they would be able to pass it on to their representatives if they asked for support to make a complaint. An attempt had been made to make the complaints procedure accessible to service users by the inclusion of pictures. This was not altogether successful and given the quality of some of the other use of images around the home, the home should find this relatively straightforward to improve the complaints procedure to make it more appropriate to the needs of the service users. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30. The environment is safe, clean and comfortable. The range of communal and provide space gives service users opportunities to socialise or spend time alone. The quality of the service users’ living space would be enhanced if the environment in the conservatory were upgraded. EVIDENCE: The two communal lounges were pleasantly decorated, had comfortable seating, display cabinets, coffee tables, televisions, and one had a fire screen, which a service user informed the inspector they had made with support from the manager. One of the kitchen/dining areas had been redecorated within the past year. The manager informed the inspector that the service users had been fully involved in the choosing the units and décor. The décor and furnishing in the conservatory was of a poor standard. There was a selection of very worn chairs that appeared to be discarded office chairs. These must be replaced. The curtain was too long and trailing on the carpet, which was stained. During the inspection this was the most heavily used area of the house and therefore urgently warrants upgrading. Three of the service users showed the inspector their bedrooms. The paintwork looked fresh in all. One service user informed the inspector that 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 17 they had chosen the clout scheme and curtains. Another had a new looking comfortable chair in their room, but they said that they had not chosen this themselves. The carpet also looked new in this room, however another service user had a carpet which appeared worn and was rucked up in places. This and the rugs in this room should be risk assessed. The manager agreed to do this. All rooms were seen to have been personalised by their occupants. The paintwork in one of the en-suite bathrooms was in need of touching up. The manager explained that cleanliness and hygiene in the en-suites could be improved if the walls were tiled. It was hoped that the organisation would be doing this. The home was clean and hygienic with no offensive odours at the time of the inspection. The smell of toilet cleaner was noticeable in the conservatory, which has two toilets leading directly off it. The manager agreed to contact the environmental health officer regarding the use of the conservatory as a dining area, given the presence of the toilets. And also in relation to laundry procedures given that laundry is transported through the kitchens and conservatory to the utility rooms. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The service users benefit from having staff who they like supporting them. EVIDENCE: One service user described activities they had been doing in the house with their key-worker. The way that they spoke about them showed that they liked them. The inspector was also told by a service user that the staff were, “OK.” There is one member of staff on duty from 7:00 to 23:00 with two staff on between 08:00 and 17:00 during the week and 10:00 to 19:00 at weekends. The rota showed that on one recent Sunday there was only one member of staff on duty all day. Many of the service users are relatively independent and can take part in activities outside the home without staff support. There are currently seven staff employed at the home, one of which is off on long-term sick leave. There are two staff vacancies. Agency staff are making up shortfalls. Because the staff team were away on a team building day at the time of the inspection, the two staff who the inspector spoke with were from and agency. They both said that they liked working in the home. One described being informed during their induction about the fire procedure and the chores that were expected of them and how to administer medication. They could not 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 19 recall having been shown service users’ care plans. The other had worked in the home before, but not for sometime. They had not had an induction since returning to the home. Staff training records were not inspected on this occasion. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Systems are in place to ensure equipment is maintained to promote the health and safety of service users and staff. EVIDENCE: Records were seen to show that the following health and safety tests were being carried out satisfactorily: Fire drills Staff fire training Fire alarm servicing and tests Emergency lighting servicing and tests Fire fighting equipment servicing and visual checks Carbon dioxide detector Portable electrical appliance tests. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 21 Advance Housing and Support carry out a programme of health and safety audits and records were seen of these occurring in May 2004, November 2004, and March 2005, with the next due in July 2005. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 70/72 Worthing Road Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 6 Regulation 15 Requirement Care plans must give sufficient detail for staff unfamiliar with the service user to be able to meet their support needs. A comprehensive medication procedure must be produced. The conservatory must be equiped with suitable chairs and the carpet attended to. Timescale for action 11/8/05 2. 3. 20 24 13 (2) 23 (2) 11/8/05 11/8/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 6 22 Good Practice Recommendations The manager should research care-planning formats and introduce a model that is appropriate to the home and the needs of the service users. Service users should be reminded of the complaints procedure and reissued with a copy if necessary. 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 24 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 70/72 Worthing Road H54 S12277 7072 Worting Road 120505 V224493.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!